CBT Toolbox for Children and Adolescents: Over 200 Worksheets & Exercises for Trauma ADHD

25 Pages·2017·1.74 MB·English

by  Lisa Phifer

CBT
Toolbox
For
Children &
Adolescents
LLIISSAA WWEEEEDD PPHHIIFFEERR,, DDEEdd,, NNCCSSPP
AAMMAANNDDAA KK.. CCRROOWWDDEERR,, MMSSWW,, LLCCSSWW
TTRRAACCYY EELLSSEENNRRAAAATT,, MMAA,, LLPPCC,, AATTRR--BBCC
RROOBBEERRTT HHUULLLL,, EEDDSS,, MMeedd,, NNCCSSPP
CBT Toolbox for Children and Adolescents © copyright 2017 by Lisa Phifer, Amanda K. Crowder, Tracy Elsenraat, Robert Hull.
Published by:
PESI Publishing & Media
PESI, Inc.
3839 White Ave.
Eau Claire, WI 54703
Cover Design: Amy Rubenzer
Editing By: Blair Davis
Layout: Amy Rubenzer & Mayfly Designs
Printed in the United States of America
ISBN: 9781683730750
All rights reserved.
Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Prosocial Skills
What Do You See? 23
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I. Childhood Trauma Cycles of Relationships 24
. . . . . . . . . . . . . . . . . . . . . . . .
Triggers and Shields, Introduction 25
. . . . . . . . . . . . . .
Triggers and Shields 26
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cognitive Skills
Competency Skills
Thinking
Cognitive Behavioral Triangle . . . . . . . . . . . . . . . . . . . 2 Resilience
My Ouch Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Power Poster, Introduction . . . . . . . . . . . . . . . . . . . . . 27
Safety Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Power Poster: Part 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Power Poster: Part 2 29
Memory . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
My Positive Thought Journal 30
Memory Cloud Walk 5 . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Memory Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Symptom Relief
Creating a Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Boo Boos and Bandages . . . . . . . . . . . . . . . . . . . . . . . . . 31
Coping Skills 32
Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thermometer 33
Communication Rules 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . .
This vs. That, Introduction . . . . . . . . . . . . . . . . . . . . . . . 9 Emotional Regulation
This vs. That . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Feeling Faces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Say It Strong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Feeling Pie . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Comfort Levels 36
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Relationship Coaching
Brain-Based Learning
Alliance Building
Building a Bridge, Introduction . . . . . . . . . . . . . . . . . 15 Connecting with the Present
Building a Bridge, Part 1: Present . . . . . . . . . . . . . . . 16 Cleaning Up Negative Thoughts . . . . . . . . . . . . . . . . 37
Building a Bridge, Part 2: Past . . . . . . . . . . . . . . . . . . 17 Grounding Exercises . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Building a Bridge, Part 3: Collaboration . . . . . . . . 18 Balloon Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Reciprocal Relationships Quieting the Body
Moods and Relationships . . . . . . . . . . . . . . . . . . . . . . . 19 Calm Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Relationship Balance, Introduction . . . . . . . . . . . . 20 Calm Down Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Relationship Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Roll a Brain Break! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Relationship Roadblocks 22
. . . . . . . . . . . . . . . . . . . . . . .
Mind and Body Competency Skills
Mind and Body Wellness Plan 43
. . . . . . . . . . . . . . . . . Time Management
Connecting the Body with Emotions,
Estimating Time 67
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Introduction 44
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Goal Setting Worksheet 68
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Connecting the Body with Emotions 45
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Visualization of Distant Rewards 69
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Exercise Diary 46
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Self-Regulation
Attention Regulator 70
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II. Attention Deficit
Action Regulator 71
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Hyperactivity Disorder
Stop and Think! Managing Impulsivity 72
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Memory
Cognitive Skills Breaking It Down 73
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Cues on Cards 74
Concentration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cognitive Flexibility, Introduction 75
Examining Inattention 48 . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
Cognitive Flexibility 76
Distraction “To Do” List 49 . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Times of Inattention 50
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Impulse Control Brain-Based Learning
Examining Impulsivity 51
. . . . . . . . . . . . . . . . . . . . . . . . . . Brain Breaks
Internal vs. External Distractions 52
. . . . . . . . . . . . . . . Calm Down Bingo, Introduction 77
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Back on Track! Coping with Distractions 53
. . . . . . Calm Down Bingo 78
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Creating a Schedule 54
. . . . . . . . . . . . . . . . . . . . . . . . . . . . Animal Break Ladder 79
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Metacognition Whole-Body Games . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Finding a Solution 54
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Healthy Habits
Thinking About My Warning Signs 55
. . . . . . . . . . . . . Healthy Plate, Introduction 81
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Reframing Thoughts 56
. . . . . . . . . . . . . . . . . . . . . . . . . . . . Healthy Plate 82
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Exercise Routine 83
Relationship Coaching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Time for Bed 84
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Alliance Building
Positive Mindset
Family Rules 57
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Positive Self-Reflection Log 85
End on a Good Note 58 . . . . . . . . . . . . . . . . . . . . .
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Positive Imagery Practice: In Control
All or Nothing and Everything in Between 59
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and Focused 86
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Reciprocal Relationships
Look at What I Accomplished! 87
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Say It or Swallow It 60
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Being a Good Friend 61
. . . . . . . . . . . . . . . . . . . . . . . . . . . . III. Autism Spectrum Disorder
Staying on Topic, Introduction 62
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Staying on Topic 63
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Cognitive Skills
Prosocial Skills
Facilitating Conversation
Boundaries 64
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Allow Me to Introduce Myself,
How Big Is My Problem? 65
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Introduction 90
Does My Reaction Match My Problem? 66 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Allow Me to Introduce Myself 91
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Conversation Map 92 Brain-Based Learning
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Conversation Toolkit 93
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Relaxation
Flexible Thinking Cool Down Checklist 120
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Flexible vs. Rigid Thinking . . . . . . . . . . . . . . . . . . . . . 94 Race Track Breathing: Warm Up or
Dealing with Detours . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Cool Down . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Embracing Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Visual Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Sensory Integration Social Thinking
Sensory Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 How Can I Help? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Sensory Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 I CAN Make a Choice . . . . . . . . . . . . . . . . . . . . . . . . . 125
Sensory Escape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Reaching Out for Help . . . . . . . . . . . . . . . . . . . . . . . . 126
Relationship Coaching Brain Games
Emotional Connection Game 127
. . . . . . . . . . . . . . . . .
Perspective
Find a Friend 128
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Perceptive Taking 100
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Conversation Cube 129
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Looking at All Sides 101
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Common Ground 102
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IV. Conduct Disorder
Emotional Expression
Emotions Cheat Sheet 103
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Cognitive Skills
Understanding Emotions 104
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What’s My Emotional Temperature? 105 Anger
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Getting to Know Your Anger 132
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Prosocial Skills
Tackling Anger Mountain 133
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Mindful Communication 106
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Weekly Anger Diary 134
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“I” Statement 101 107
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“I” Statements vs. “You” Statements 108 Aggression
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Times of Acting Out: Introduction 135
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Competency Skills
Times of Acting Out: Client 136
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Managing Expectations Times of Acting Out: Caregiver . . . . . . . . . . . . . . . 137
Is it an Emergency? . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Times of Acting Out: Plan of Action . . . . . . . . . . 138
Expected vs. Unexpected 110
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Examining Expectations 112
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Going Back in Time 139
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Functional Interactions Recognizing Emotional Limits . . . . . . . . . . . . . . . 140
My Personal Bubble . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Body Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Control My Volume 114
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Relationship Coaching
Appropriate Touching 115
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Communication
Thought Challenging
I Feel 142
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Perseveration Log 116
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Watch Your Words 143
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Perseveration Information 117
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Communicating with Others 144
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Perseveration Action Plan, Introduction 118
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Perseveration Action Plan 119 Alliance Building
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Understanding Family Rules 145
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Friends and Family 146
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Respecting Myself and Others 147 Anxiety Hierarchy, Introduction 173
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Anxiety Hierarchy 174
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Prosocial Skills
Your Worry 175
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Prosocial Behaviors 148
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Helpful Behaviors 149 Thought Distortion
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Helpful Self 150 “Good” Worry vs. “Bad” Worry 176
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Detective 177
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Competency Skills
Weighing Your Worries 178
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Sequencing
Physical Reactions/Somatization
Behavior Sequencing, Introduction 151
. . . . . . . . . . . . Responses, Reactions, and Feelings 179
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Behavior Sequencing: Part 1 152
. . . . . . . . . . . . . . . . . . . How Do You Respond to Your Worry? 180
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Tipping Point: Part 2 153
. . . . . . . . . . . . . . . . . . . . . . . . . . Thoughts and Feelings Log 181
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Behavior Sequencing Redo: Part 3 154
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Relationship Coaching
Emotion Regulation
Control Cards 155 Alliance Building
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Reframing Thoughts 156 Talking with Others 182
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Change of Mind 157 Helpful Thinking 183
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Trust Bubble 184
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Emotional Vocabulary
Building Emotional Vocabulary 158 Assertiveness
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Linking Emotions, Thoughts, and Feelings 159 Assertiveness Regulator 185
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Feeling States 160 Three Wishes 186
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To Do, Won’t Do List 187
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Brain-Based Learning
Prosocial Skills
Creating Peace
Prosocial Behaviors 188
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Peace Chain 161
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Peaceful Actions 162
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fear/Anxiety Self-Statements 190
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Thinking Peace 163
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Competency Skills
Body Control
Recipe for Success 164 Problem Solving
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Yell It from the Mountaintop 165 Red Light, Yellow Light, Green Light 191
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10-Point Check-In 166 Creating Your Own Coping Kit 192
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Stay Calm Checklist 193
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Gratitude
Letter of Thanks 167 Control
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Little Victories 168 Circle of Control 194
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Grateful Feelings 169 Managing Expectations of Control 195
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Controlling Your Thoughts 196
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V. Anxiety
Thought Challenging
What Will Work? 197
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Cognitive Skills How Do We Get There? . . . . . . . . . . . . . . . . . . . . . . . 198
Stop, Rewind, Rethink, Introduction 199
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Defining Anxiety
Stop, Rewind, Rethink 200
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Getting to Know Your Worry 172
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Brain-Based Learning Supportive Alliance
Supportive Responses 227
Positive Changes . . . . . . . . . . . . . . . . . . . . . . . . .
Understanding Stress and Support 228
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Within Reach! 201
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Support Constellation 229
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26 Positive Traits 202
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Self-Care Routine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 Self-Esteem
I Like Me! 230
Perspective Changing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Awards, Introduction 231
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Staying in the Present, Introduction 204
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Awards 232
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Staying in the Present 205
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I Am Valuable 233
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Let’s Box It Away 206
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You’re Not Alone 207
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Competency Skills
Brain Games
Realistic Thinking
Relaxation Rolls 208
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Mandala 209
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Optimistic Views 235
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Anxiety the Alien, Introduction 210
. . . . . . . . . . . . . . Test Your Thinking 236
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Anxiety the Alien 211
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Coping
Positive Self-Talk, Introduction 237
VI. Depression . . . . . . . . . . . . . . .
Positive Self-Talk 238
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The Four Questions 239
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Cognitive Skills Coping Skills Tree 240
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Mood Problem Solving
Understanding Your Mood . . . . . . . . . . . . . . . . . . . 214 Stoplight Problem Solving . . . . . . . . . . . . . . . . . . . . 241
Mood Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 Finding Another Solution . . . . . . . . . . . . . . . . . . . . 242
Building Your Defense, Introduction . . . . . . . . . 216 Reaching Out . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Building Your Defense 217
. . . . . . . . . . . . . . . . . . . . . . . . .
Brain-Based Learning
Isolation
Fostering Motivation
Social Interaction and Mood 218
. . . . . . . . . . . . . . . . . .
What Drives You? 244
People Around Me 219 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Positive Goal Setting 245
Support Chain 220 . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Self-Improvement Plan 246
. . . . . . . . . . . . . . . . . . . . . . .
Emotional Expression
Positive Changes
My Feelings 221
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Connecting with Your Body 247
Uncut Diamond 222 . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Making Positive Changes 248
Inside Out 223 . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Self-Care Plan 249
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Relationship Coaching
Healthy Body
Confidence Get Moving! 250
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I Am … . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224 Sleep Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Your Inner You . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Emotional Eating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
Self-Portrait 226
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Introduction
CBT Toolbox for Children and Adolescents was designed with therapists in mind to provide brief,

targeted solutions to a myriad of mental health issues that are frequently present in children. The
activities in this workbook enhance traditional CBT by promoting the development of a child’s
executive functioning, developing social skills, and prompting whole brain approach. Traditional
therapy relies heavily on language and the activities in this book accompany language with nonverbal activities
to help facilitate growth with individuals who have difficulties reflecting and changing their own negative
thinking. This book used a multidisciplinary approach relying on the expertise of school psychologists, social
workers and therapists. We have put together an abundance of creative ideas that can engage and inspire
allowing clients to express themselves, communicate with others and create positive change.
The workbook covers six clinical areas: Childhood Trauma, Attention Deficit Hyperactivity Disorder, Autism
Spectrum Disorder, Conduct Disorder, Anxiety, and Depression. The activities are tailored to specific disorders
and symptomology and can be combined to meet the client’s needs in regards to interrupting negative thought
patterns, developing healthy relationships, and creating a mind-body connection. Within each chapter are four
content areas tailored to the specific disorder.
1. Cognitive Skills
These activities focus on recognizing symptoms, determining the impact of negative thinking patterns,
and enhancing memory strategies.
2. Relationship Coaching
These activities focus on the development of prosocial behavior, building alliances, and improving
interpersonal relationships.
3. Competency Building
These activities target emotional regulation, realistic thinking, coping, and problem solving.
4. Brain-Based Learning
These activities focus on developing a mind-body connection, finding motivation, and developing
healthy mental and physical habits.
How to Use this Book
This workbook provides activities to address countless symptoms with skill-building exercises. You will notice
three types of worksheets: In-session Exercise, Client Activity and Caregiver Worksheet. These handouts have
different uses and each one is written from a different perspective.
In-session Exercises are designed for the therapist to use as a tool while in-session. Including the client,
caregiver and therapist in one setting, they are made to spark conversation and make the client comfortable.
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Client Activities are created for the child to do themselves either in-session or as homework. Whether
supervised by the therapist or their caregiver, they will be able to do the activity at any age or stage in the
treatment process.
Caregiver Worksheets are for the parent or caregiver-to help them cope and work with the therapist, and also
allow them to become part of the therapy process and reinforce strategies being taught in-session.
Although suggestions, ideas, and specific instructions are given, we encourage creativity within your own setting
and specialty. These activities can be used to engage children directly in therapy, used in a group format for at-
risk children, or as a strength building competency activity. As every therapist knows, skills that are repetitively
practiced outside of therapy have a greater chance of being retained and used when faced with challenges.
Think Outside the PAGE
Let these activities act as a springboard to your own creativity. All these activities can be adapted to meet your
client’s age, developmental capacity, or current stage in treatment. It is important to let the client dictate when a
piece is completed and how much they would like to expand the given directive. If a client is invested in a certain
activity, you may consider letting him or her work on it over several sessions to maximize your information
gathering. A loosely structured approach allows more opportunities for your client to encounter challenges in
the process, which will result in opportunities for problem solving, skill building, and relationship building.
Keep in mind that once an activity is completed, the client’s processing of those skills continues.
Go Beyond the Activity Itself!
The activity or art piece is significantly important to the therapeutic process, the dialogue about the activity is
equally important. Consider having the client title each activity and journal about it. Engage in discussions with
the client regarding his or her feelings about this process of creating by using nonjudgmental commentary and
open-ended questioning.
The artwork is an extension of self to be honored; therefore, it is important to have a plan for what to do with
completed pieces to honor them and protect them. This ritual offers closure to the creative process. Options to
consider include creating a portfolio to keep in the office until treatment is ended or for the client to take home.
You may also find a safe place for the artwork to be on display in the office or use the artwork in other treatment
activities; for example, many of the pieces created in session would double nicely as a focal point for guided
imagery activities. The artwork could also be used in the client’s home as a daily reminder of skills to practice or
as a banner of pride and accomplishment. Process these options with the client ahead of time and come to an
agreed plan.
Keep in mind that once an activity is completed, the client’s processing of those skills continues. There are
therapeutic advantages to repeating activities at different points in the therapeutic process. You might consider
having the client do the activity again in the same way it was done before and then process the differences.
Another option would be to complete a similar version of the activity to better meet where the client is at that
particular point in treatment. Both options offer the client opportunity for repetition and mastery.